How To Prevent Acute Mountain Sickness (AMS), HAPE and HACE

In this post, I’m talking about something you would surely want to know – avoiding altitude sickness.

I’d like to first put a disclaimer — there’s no fool-proof way of preventing altitude sickness.

All these methods I’m putting down will reduce your chances of getting altitude sickness. And from our experience, they’re worth it.

I’m going to break this down into three parts.

1. Your itinerary

As you already know, altitude sickness occurs when your body has not acclimatised well enough to the altitude.

So giving your body enough time to acclimatise is the most effective way to avoid altitude sickness.

That’s why you’ll see that we have “acclimatisation days” on our high altitude treks like Rupin Pass, Roopkund and Goechala. These are days where you simply rest at a particular campsite, without too much exertion.

So splitting your itinerary as much as possible and taking it slow is most effective in preventing altitude sickness.

However, keep in mind that the amount of time required to acclimatise is different for every individual. Ideally, you should increase your sleeping altitude just by 1,000 ft everyday.

But the Indian Himalayas climb very quickly. The difference in altitude between camps is high, usually between two and three thousand feet. This is because there is either no place to camp in between or there are no water sources etc.

We call this a “forced accent”. You are forced to ascend more than required.

This makes you more susceptible to altitude sickness.

There are some ways to manage this.

2. A preventive course of Diamox

There are certain medicines that help you acclimatise faster.

Trekkers and mountaineers all over the world use a medicine called Acetazolamide (Diamox) to acclimatise faster.

In fact, even for those who suddenly go up to high altitudes, like those who drive or fly to Leh, we recommend Diamox.

Dosage: Start with a dosage of 125 mg (half a tablet) every 12 hours 2 days prior to your trek (usually when you arrive at Delhi). Increase it to 250 mg (full tablet) every 12 hours from the day you get to the base camp and continue until you complete the trek.

Don’t stop the course in between.

Side effects: There aren’t too many side effects of taking Diamox. You feel a numbness/tingling sensation in your hands and feet. You pee more often (which means the medicine is doing its job). Some claim that they get a bit of loosies after Diamox. Generally, a Digene takes care of this.

Keep in mind that Diamox is a sulfa-based drug. If you’re allergic to sulphides, avoid Diamox.

As an alternative to Diamox, you could keep a strip of Dexamethasone tablets with you. This is a steroid and reduces muscle inflammation in the body. It does not help speed up acclimatisation per se. So if you get hit by AMS, take Dex as an alternative. The dosage is 4 mg every six hours. Avoid taking Dex as preventive medicine though.

While Diamox reduces the chances of AMS hitting you, it isn’t a fool-proof medicine. Even those who are on a course of Diamox can get hit by AMS.

So it’s important for your body to do its bit to acclimatise.

3. Working on your fitness

It’s imperative that you prepare your body to function well with lesser oxygen. You can do this by simply increasing your cardiovascular endurance.

What’s that?

Cardiovascular endurance is basically the ability of your lungs, heart and blood vessels to deliver oxygen to your body. Naturally, someone with higher cardiovascular endurance has a higher probability of acclimatising faster to high altitude.

Although there’s no proven correlation between altitude sickness and fitness, we can talk from experience. On our treks, we have found that it’s usually unfit people who are more prone to AMS. When I’m talking about unfit, I’m not talking about overweight or underweight. I’m talking about plain physical endurance.

Funnily though, we’ve also seen that super fit trekkers climb too quickly, and then suffer from AMS at the next camp. If you are fit, keep the ego behind. Climb slowly.

Do hydration, good diet and warmth help prevent altitude sickness?

By themselves, none of them are strong points to keep altitude sickness at bay. But together, they help in the general well-being of your body which could reduce chances of altitude sickness.

Hydration helps your body function smoothly. You need at least 4 litres of water every day on a high altitude trek. Every time you urinate, drink enough water, to keep the colour as close to colourless as possible. If it is deep coloured you know you are dehydrated.

Even diet plays an equally important role. It’s important to eat well at high altitude, but not eat too much. We don’t recommend a diet that’s very high on protein. High protein is harder for your body to break down. That’s why we don’t serve meat on our treks. A low-salt, wholesome meal is what we recommend.

Warmth is especially required when you expect temperatures below 5 degrees (which happens on most Himalayan treks). You must especially keep your head, your core, your hands and feet warm. So having enough layers, a woollen cap, gloves and woollen socks is mandatory on high altitude treks. We have seen far too many trekkers in just one or two layers of clothes telling us that they are OK with the cold, that they are not feeling cold. They are simply being heroic, but their core body temperature is dropping.

Things to avoid

Alcohol is a big NO, especially if you are not acclimatised to the altitude. I made a video on why it is bad for you a while ago. Watch it here.

Smoking anything is not good either because it’s directly inhibiting the capacity of your lungs to to send out oxygen to your body.

Both, drinking and smoking, cause dehydration and that’s the last thing you need on your trek!

Overexertion is again something you must avoid at high altitude. Don’t try to cram too much into your itinerary. Take it slow and give your body the rest it needs.

A re-cap

With that, I’m ending my 4-part series on altitude and the body. I hope these articles have left you more informed and that you’ll be able to identify and tackle altitude sickness if you see it.

I’m putting down the links to the previous articles here. Make sure you bookmark them for future use.

Swathi Chatrapathy is the Chief Editor at Indiahikes. She also runs a video series, Trek With Swathi. Before joining Indiahikes, she worked as a reporter and sub-editor at Deccan Chronicle. She holds a Masters in Digital Journalism and continues to contribute to publications such as Deccan Herald. Trekking, to her, is a sport that liberates that mind like nothing else can.Read Swathi's other articles. Watch Swathi's video series here.

Hi Swathi , I am going on buran Ghati trek for 7 days. Should I take preventative course of diamox by taking 125mg in every 12 hrs. If yes, should I start this from day 1 of trek or after reaching a certain altitude like 8000 ft ? Please answer quickly.

Hi! Going on a preventive course of Diamox isn’t necessary for any individual visiting Leh, irrespective of their age, provided adequate time (two days of rest and small walks after reaching) is reserved for acclimatization. However, if your daughter develops symptoms of AMS, you can give her half a tablet of Diamox (125 mg) and take her to the nearest hospital if symptoms persist.

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About Author

Swathi Chatrapathy is the Chief Editor at Indiahikes. She also runs a video series, Trek With Swathi. Before joining Indiahikes, she worked as a reporter and sub-editor at Deccan Chronicle. She holds a Masters in Digital Journalism and continues to contribute to publications such as Deccan Herald. Trekking, to her, is a sport that liberates that mind like nothing else can.